Treatment of Myasthenia

About the disease

Myasthenia affects the skeletal muscles that are responsible for voluntary movement. As the disease develops, muscles and nerve cells stop communicating properly due to an interruption at the neuromuscular junction (where nerve cells connect with the muscles they control) and wrong signals are sent to the brain. As a result, the muscles are not able to fully contact anymore and the sufferer starts to feel weak.

According to the website Healthline, this disease affects on average 17 people out of 100,000 in the USA. Although the exact cause of myasthenia is not known, doctors believe that certain autoimmune diseases contribute to the development of this neuromuscular condition. An autoimmune disease develops when the immune system starts to fight against itself for some unknown reason. This can lead to problems with nerve transmission. There is also a theory that myasthenia is caused by certain viral and bacterial infections that damage muscles.

There are no known cases of myasthenia in children or young adults; it usually appears after the age of 40.

Symptoms

• Muscle weakness
• Inability to walk long distances
• Fatigue
• Pain while chewing
• Vision problems
• Coordination problems

Diagnosis

• During a physical examination, the doctor will check the patient’s muscle reflexes. This is to find out if the signalling system between the patient’s nerves and muscles has been compromised. The doctor will also check different parts of the patient's body using palpation to see if there is any loss of sensitivity.
• The patient may undergo a neurological test whereby their nerves are stimulated in order to see if they function properly. 
• CT and MRI scans provide images that help the doctor to estimate the extent of the patient’s muscle weakness. The scans can also help to rule out other conditions that could be causing it.

Treatment

• Conservative treatment is used to alleviate pain and improve the patient’s coordination. Special medications are used to normalize vision if it has been affected by this disease. Immunosuppressants are used to reduce the effect of autoimmune disease, allowing the muscles to regain strength.
• Surgery may be required to resect the thymus gland. Once this lymphoid organ is removed, the immune system becomes suppressed, thereby improving the connection between the nerves and muscles.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko